A shocking revelation has emerged from a recent study conducted by the University of South Australia: up to 50% of chemotherapy patients are missing out on crucial podiatry care, despite the severe and often permanent nerve damage that can occur in their lower limbs. This gap in cancer survivorship care is a serious issue that demands our attention.
The study, a first of its kind, assessed the use of podiatry services by individuals at risk of developing Chemotherapy-Induced Peripheral Neuropathy (CIPN). CIPN causes a range of distressing symptoms, including numbness, tingling, pain, and weakness in the feet. Yet, despite the debilitating nature of this condition, fewer than one in five patients sought podiatry assistance, even years after their treatment.
The research focused on 3292 people with colorectal cancer, the majority of whom received the standard chemotherapy drug, Oxaliplatin, a known culprit of CIPN. Sindhrani Dars, a UniSA PhD candidate and podiatrist, emphasizes the urgency of addressing this gap. "Colorectal cancer treatment heavily relies on neurotoxic chemotherapy, and CIPN is a painful and debilitating side effect," she explains.
Neurotoxic chemotherapy can lead to permanent nerve damage in the feet, causing a loss of feeling, burning sensations, and a pins-and-needles numbness. This not only reduces balance and muscle strength, increasing the risk of falls and foot injuries, but it also significantly impacts quality of life. In some cases, the severity of CIPN symptoms leads patients to reduce or even stop their chemotherapy treatments altogether.
"As registered allied health professionals, podiatrists are skilled in managing lower limb complications and can provide vital support to those undergoing or recovering from chemotherapy," Dars says. "However, as our research shows, many cancer patients are unaware of the benefits podiatry can offer."
With a high prevalence of CIPN among cancer patients receiving chemotherapy, it's crucial that podiatry becomes an integral part of routine oncology care. Currently, there are no Australian guidelines for CIPN management, and the only published clinical pathway excludes podiatry services. This lack of awareness among patients and treatment teams is a significant concern.
"The high incidence of CIPN is well-documented, but with less than 20% of chemotherapy patients accessing podiatry, there's a worrying gap in care," Dars notes. "Podiatry must play a more prominent role in cancer care, and we need to establish better referral pathways in oncology settings to ensure this happens."
The research team, with input from Australian podiatrists, has developed clinical recommendations to guide the care and management of CIPN symptoms. These recommendations are available online and provide a much-needed resource for healthcare professionals and patients alike.
This study highlights the importance of interdisciplinary care in oncology and the potential for podiatry to significantly improve the lives of cancer patients. With no evidence-based strategies to prevent or reverse CIPN, the role of podiatry in cancer survivorship care cannot be overstated. Early podiatric assessment can prevent falls, reduce pain, improve mobility, and enhance overall recovery and well-being.
And here's where it gets controversial: should podiatry be an optional add-on, or is it an essential component of comprehensive cancer care? What do you think? Share your thoughts in the comments and let's spark a conversation about this vital yet often overlooked aspect of cancer treatment and survivorship.
